What Does a Physiatrist Do?

Physiatrists specialize in non-surgical care for conditions that cause pain and impair normal, everyday functions. These conditions include neuromuscular disorders that affect nerves, muscles, and bones.

Zacharia Isaac, MD, and Shirley L. Shih, MD, Mass General Brigham physical medicine and rehabilitation specialists, answer common questions about physiatry and how patients can benefit from the care of a physiatrist.

Dr. Isaac serves as chief of spine care and pain management at Spaulding Rehabilitation Hospital and associate chairman of physical medicine and rehabilitation at . Dr. Shih is medical director of the Spaulding Traumatic Brain Injury Service.

Learn about the many ways physiatrists help patients restore function and improve their quality of life.

What does a physiatrist treat?

Physiatrists not only have a keen understanding of how the body works and the medical issues at play, but also understand how these medical issues can affect a patient’s mobility, self-care, mood, and quality of life. Through their breadth of training, physiatrists aim to rehabilitate the whole person, addressing their physical, emotional, medical, and vocational needs.

Along with their standard medical training, many physiatrists also pursue training in one or more of the following subspecialties:

• Musculoskeletal (orthopedic) rehabilitation

• Spinal cord injury

• Brain injury medicine

• Neuromuscular medicine

• Sports medicine

• Pain medicine 

• Pediatrics

• Cancer rehabilitation

How do physiatrists care for patients?

A physiatrist may see patients in a variety of care settings including outpatient clinics, acute care hospitals, inpatient rehabilitation hospitals, and skilled nursing facilities. Their treatment involves on educating patients about their diagnosis and coordinating a multidisciplinary approach to non-operative care. Treatment focuses on restoring function, reducing pain, and improving quality of life.

A physiatrist may:

• Explain the benefits and role of exercise therapy, instructing patients about proper exercise techniques and regimen guidelines

• Establish a physical therapy, occupational therapy, or speech therapy regimen

• Counsel patients about ways to improve their overall health, such as quitting smoking and maintaining a healthy weight

• Prescribe and manage a medication regimen, with a focus on non-opiate therapies

• Administer minimally invasive injections to the joints, nerves, or other painful structures to treat pain and restore function

• Prescribe braces, splints, and prosthetics to improve mobility and restore function

• Prescribe assistive devices including wheelchairs, walkers, and canes

• Refer to home health care and outpatient services for additional supports and resources in the community

• Refer to psychosocial support

• Refer to alternative therapies, such as medical acupuncture

When non-operative measures fail to effectively treat pain and restore function, physiatrists can refer patients to a surgical specialist for further evaluation.